slideshow: gluteal region
TRANSCRIPT
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The Gluteal Region
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The Gluteal Region lies on the
posterolateral aspect of the pelvis
posterior view
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The Gluteal Region lies on the
posterolateral aspect of the pelvis
It is occupied by large powerful
muscles Several important nerves and vessels traverse this area
posterior view
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Muscles of the Gluteal Region
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Largest and most superficial muscle
Has an extensive origin from-lateral surface of ala of ilium posterior to posterior gluteal line-posterior surface of sacrum and coccyx - sacrotuberous ligament
Gluteus Maximus
right gluteal region
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Gluteus Maximus
Iliotibial Iliotibial TractTract
Largest and most superficial muscle
Its coarse fibers run obliquely downwards and laterally behind the hip joint
Most of the muscle inserts into the Iliotibial Tract
right gluteal region
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Gluteus Maximus
Iliotibial Iliotibial TractTract
It extends the Hip Jointand
laterally rotates the Hip Joint
right gluteal region
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Gluteus Medius
Lies beneath Gluteus Maximus
Originates from the lateral surface (gluteal surface) of the Ilium,
between the anterior and posterior Gluteal Lines.
right gluteal region
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Gluteus Medius
It runs above the hip joint
Inserts onto the lateral aspect of the Greater
Trochanter
right gluteal region
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Gluteus Medius
Gluteus MediusGluteus Medius
Gluteus Maximus, Gluteus Maximus, turned away to turned away to reveal Gluteus reveal Gluteus MediusMedius
Iliotibial TractIliotibial Tract
It runs above the hip joint
Inserts onto the lateral aspect of the Greater
TrochanterIt abducts the Hip Joint
right gluteal region
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Gluteus Minimus Gluteus Medius is cut
Lies beneath Gluteus Medius
Originates from lateral surface of Ilium between the anterior
and inferior Gluteal Lines
right gluteal region
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Lies beneath Gluteus Medius
Originates from lateral surface of Ilium between the anterior
and inferior Gluteal Lines
Gluteus Minimus
Inserts onto anterior aspect of the Greater Trochanter of the
Femur
right gluteal region
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Gluteus Minimus
Inserts onto anterior aspect of the Greater Trochanter of the
Femur
Gluteus Medius is cut
Gluteus Minimus
Gluteus Medius is cut and reflected downwards
Lies beneath Gluteus Medius
Originates from lateral surface of Ilium between the anterior
and inferior Gluteal Lines
right gluteal region
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Greater Sciatic Foramen
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One of the major gateways between the
pelvic cavity and the lower limb
The Greater Sciatic Foramen
posterior view
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The Greater Sciatic Foramen
Formed by the Greater Sciatic Notch
and Sacrospinous ligament
attaching to the Ischial Spine
Sacrotuberous Ligament
One of the major gateways between the
pelvic cavity and the lower limb
posterior view
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The Greater Sciatic Foramen
Sacrotuberous Ligament
One of the major gateways between the
pelvic cavity and the lower limb
posterior view
Formed by the Greater Sciatic Notch
and Sacrospinous ligament
attaching to the Ischial Spine
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A number of
− Muscles− Arteries and Veins − Nerves
pass through the Greater Sciatic Foramen
The Greater Sciatic Foramen
Sacrotuberous Ligament
posterior view
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Muscles related to the Greater Sciatic Foramen
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Piriformis
Lies centrally in the gluteal region
Originates from the
−anterior surface of lateral process of sacrum
−dorsal aspect of ilium around margin of the greater sciatic notch
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Piriformis
Inserts onto the upper border of
Greater Trochanter
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Iliotibial TractIliotibial Tract
Gluteus Gluteus MaximusMaximus
Gluteus Gluteus MediusMedius
PiriformisPiriformis
Sciatic Sciatic NerveNerve
Piriformis
Externally rotates the hip joint when the thigh is extended
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Obturator Internus
Originates from the
-inner surface of obturator membrane and contiguous bone
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PiriformisPiriformisGluteus MediusGluteus Medius
Gluteus MaximusGluteus Maximus(turned away)(turned away)
Obturator InternusObturator Internus
Sciatic NerveSciatic Nerve
Obturator Internus
Common insertion with Superior and Inferior Gemelli
onto medial aspect of Greater Trochanter of Femur
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Superior Gemellus
Originates from a small area on the outer surface of hip bone below
Ischial Spine
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Superior Gemellus
Inferior Gemellus
Originates from the superior aspect of the Ischial Tuberosity
Originates from a small area on the outer surface of hip bone below
Ischial Spine
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Superior Gemelli&
Inferior Gemelli
Insert in common with
Obturator Internusvia the Tricipital Tendon
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PiriformiPiriformiss
Obturator Obturator InternusInternus
Gluteus MediusGluteus Medius
Gluteus MaximusGluteus Maximus(reflected inferiorly)(reflected inferiorly)
Sciatic NerveSciatic Nerve
Superior Superior GemellusGemellus
Inferior Inferior GemellusGemellus
Superior Gemellus&
Inferior Gemellus
Insert in common with
Obturator Internusvia the Tricipital Tendon
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Quadratus Femoris
Originates from the lateral aspect of the Ischial Tuberosity
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Quadratus Femoris
Originates from the lateral aspect of the Ischial Tuberosity
Inserts onto Quadrate tubercle on
Intertrochanteric Crest and adjacent area of posterior
Femur
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Originates from the lateral aspect of the Ischial TuberosityPiriformiPiriformi
ss
Gluteus MediusGluteus Medius
Gluteus MaximusGluteus Maximus(reflected inferiorly)(reflected inferiorly)
Sciatic NerveSciatic Nerve
Quadratus Quadratus FemorisFemoris
Quadratus Femoris
Inserts onto Quadrate tubercle on
Intertrochanteric Crest and adjacent area of posterior
Femur
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PiriformiPiriformiss
Obturator Obturator InternusInternus
Gluteus MediusGluteus Medius
Gluteus MaximusGluteus Maximus(reflected inferiorly)(reflected inferiorly)
Sciatic NerveSciatic Nerve
Collectively
•Superior Gemellus•Inferior Gemellus •Obturator Internus•Quadratus Femoris
Superior Superior GemellusGemellus
Inferior Inferior GemellusGemellus
are known as the
Short Lateral Rotators of the Hip Joint
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Structures that crossThe Greater Sciatic Foramen
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Nerves of the Gluteal Region
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Gluteus Minimus
Piriformis
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Superior Gluteal Nerve
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Superior Gluteal Nerve
Emerges superior to Piriformis and splits into
-Superior division that supplies Gluteus Medius
-Inferior division that supplies Gluteus Minimus
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Sciatic Nerve
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Sciatic Nerve
Thickest nerve in the body2cm at origin
Emerges below Piriformis
Divides into its two components in the posterior thigh•Tibial Nerve•Common Peroneal Nerve
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Inferior Gluteal Nerve
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Inferior Gluteal Nerve
Arises from dorsal divisions of
•5th Lumbar •1st and 2nd sacral ventral rami
Supplies Gluteus Maximus
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Posterior Cutaneous Nerve of the Thigh
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Posterior Cutaneous Nerve of the Thigh
Purely sensory and mainly cutaneous nerve
Arises from sacral plexus
-2nd, 3rd and 4th sacral ventral rami
Supplies gluteal and perineal region and back of lower limb
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Nerve to Obturator Internus
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Nerve to Obturator Internus
Arises from ventral divisions of-5th Lumbar ventral rami-1st and 2nd Sacral ventral rami
Supplies -Obturator Internus-Superior Gemellus
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Nerve to Quadratus Femoris
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Nerve to Quadratus Femoris
Arises from ventral divisions of-4th, 5th Lumbar ventral rami-1st Sacral ventral ramus
Supplies -Quadratus Femoris-Inferior Gemellus
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Pudendal Nerve
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Pudendal Nerve
Arises from ventral rami of 2nd, 3rd and 4th sacral nerves
Exits the pelvis via the Greater Sciatic Foramen and enters the perineum
through theLesser Sciatic Foramen
Supplies Perineal structures
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Perforating Cutaneous Nerve
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Perforating Cutaneous Nerve
Arises from posterior aspect of 2nd, 3rd sacral ventral rami
Pierces Sacrotuberous Ligament supplies skin over
inferior and medial part of buttock
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Superior Gluteal Artery
Branch of the Internal Iliac Artery
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Superior Gluteal Artery
Branch of the Internal Iliac Artery
Supplies muscles of the gluteal region and hip joint
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Inferior Gluteal Artery
Branch of the Internal Iliac Artery
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Inferior Gluteal Artery
Branch of the Internal Iliac Artery
Supplies muscles of the gluteal region and hip joint
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Summary of Muscles of the Gluteal Region
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Gluteus Maximus Origin Gluteal surface of ilium
posterior to posterior gluteal line, posterior superior iliac crest, dorsal sacrum and coccyx, and sacrotuberous ligament
Insertion Iliotibial tract (band); gluteal tuberosity posterior femur
Action Extends and laterally rotates hip
Nerve Supply Inferior gluteal nerve (L5, S1, S2)
Blood Supply Inferior and superior gluteal arteries
Gluteal Region
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Gluteus Medius Origin Outer surface of ilium between
posterior and middle gluteal linesInsertion Lateral surface of greater
trochanter of femurAction Abducts thigh; medially rotates
hipNerve Supply Superior gluteal nerve (L4, L5, S1)
Blood Supply Superior gluteal artery
Gluteal Region
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Gluteus MinimusOrigin Outer surface of ilium between
inferior and anterior gluteal linesInsertion Anterior surface of greater
trochanter of femurAction Abducts and medially rotates the
hip jointNerve Supply Superior gluteal nerve (L4, L5, S1)
Blood Supply Superior gluteal artery
Gluteal Region
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PiriformisOrigin Anterior surface of lateral
process of sacrum and gluteal surface of ilium at the margin of the greater sciatic notch
Insertion Superior aspect greater trochanter of femur
Action Lateral rotator of the hip jointNerve Supply Anterior primary rami S1, S2 Blood Supply Superior and inferior gluteal
arteries
Gluteal Region
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Gluteal Region Obturator Internus
Origin Inner surface of obturator membrane and adjacent bone
Insertion Medial aspect greater trochanter of femur, in common with superior and inferior gemelli
Action Laterally rotates hip
Nerve Supply Nerve to the obturator internus (L5, S1, S2)
Blood Supply Internal pudendal and superior and inferior gluteal arteries
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Gluteal Region Superior Gemellus
Origin Outer surface hip bone below Ischial spine
Insertion Medial surface of greater trochanter of femur, in common with obturator internus
Action Laterally rotates hipNerve Supply Nerve to the obturator
internusBlood Supply Inferior gluteal artery
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Gluteal Region Inferior Gemellus
Origin Superior aspect ischial tuberosity
Insertion Medial surface of greater trochanter of femur, in common with obturator internus
Action Laterally rotates hipNerve Supply Nerve to quadratus femoris
(L4, 5, S1)Blood Supply Inferior gluteal artery
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Gluteal Region Quadratus Femoris
Origin Lateral border ischial tuberosity
Insertion Quadrate tubercle and adjacent bone of intertrochanteric crest of posterior aspect femur
Action Laterally rotates hipNerve Supply Nerve to the quadratus
femorisBlood Supply Medial circumflex femoral
artery, inferior gluteal artery, obturator artery